Ambala

Researchers are investigating the reasons why some adults with diabetes have difficulty taking their medications as prescribed. This observational study focuses on understanding the many factors influencing medication adherence, which is crucial for controlling blood sugar and avoiding complications. The study uses an integrated Health Ecology and Capability-Opportunity-Motivation-Behavior COM-B framework to explore how individual understanding, social support, healthcare communication, and practical challenges affect medication-taking behavior. Participants are adults with diabetes who are receiving long-term medication and attending routine outpatient care. They will complete structured questionnaires and have their prescription records reviewed during a single clinical visit. The study does not involve any treatment or follow-up visits. The assessment covers individual factors like medication literacy and beliefs, interpersonal influences such as family support, healthcare interaction quality, and structural barriers like medication cost and access. During one outpatient encounter, participants will answer validated questionnaires about medication adherence and its influences. Researchers will review prescriptions to evaluate regimen complexity. The main outcome measured is medication adherence, with additional assessments on medication literacy, beliefs about medicines, family involvement, social support, and communication quality. No interventions are given, and data collection occurs only once, aiming to inform future strategies to improve adherence in diabetes care.

Researchers are evaluating the impact of two different default dialysate sodium concentrations on major cardiovascular events and death in adults receiving maintenance haemodialysis for end-stage kidney disease. This pragmatic, cluster-randomised, open-label Phase 4 study compares sodium levels of 137 mmoll and 140 mmoll in real-world dialysis settings across multiple sites globally. Dialysis sites will be randomly assigned to use either a default dialysate sodium concentration of 137 mmoll or 140 mmoll for at least 90% of dialysis sessions. Other aspects of patient care will follow standard local practices. Sites must consent to participate, and individual patients will provide waiver or opt-out consent. The study expects to enroll sites over 5 to 7 years, with each participant followed for approximately 2 to 5 years until the study endpoints are reached. Participants will receive dialysis at their assigned sites with the designated sodium concentration. Researchers will monitor the time to first occurrence of major cardiovascular events or death as the primary outcome. Secondary outcomes include other cardiovascular events and individual components of the composite outcomes. Data collection and patient monitoring will continue throughout the study period, estimated to last around five years per participant.

Researchers are conducting an observational study to develop and validate a new patient-reported questionnaire called the Liver Cirrhosis Cognitive Decline Scale LiCCoS. This tool aims to identify cognitive difficulties such as forgetfulness, slowed thinking, and trouble with daily mental tasks that often occur in adults with liver cirrhosis but are frequently missed in routine care. The study focuses on adults aged 18 to 75 years with a confirmed diagnosis of liver cirrhosis and explores how well LiCCoS measures cognitive issues compared to standard tests and disease severity. The study involves multiple phases including item generation from patient interviews, expert review for content validity, pilot testing for clarity, and a larger validation phase assessing psychometric properties like reliability and construct validity. Participants will complete the LiCCoS questionnaire and standard cognitive screening tests once during a routine outpatient visit or via a secure online platform. No treatments or changes in medical care are involved, as this is purely observational. Participants will provide basic background information and complete cognitive assessments to help researchers evaluate the accuracy and usefulness of LiCCoS. Data collection includes quality assurance measures to ensure accuracy and completeness. The main outcome is the questionnaires psychometric validity and reliability, along with its relationship to standard cognitive tests and liver disease severity. The study will support early detection of cognitive problems in liver cirrhosis and enhance communication with healthcare providers.